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目的探究骨转换标志物在绝经后女性骨质疏松性骨折风险中的预测价值。方法 2013年6月-2015年6月就诊的1 560例患者中选取51例绝经后骨质疏松性骨折患者为实验组,84例对应年龄段骨质疏松未发生骨折绝经后女性为对照组,分别检测2组各患者血清Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、Ⅰ型前胶原N端前肽(P1NP)值,同时检测各受试者髋部或脊柱骨密度。通过对2组相关资料进行比较分析,并借助ROC曲线评价β-CTx、P1NP对骨质疏松性骨折风险的作用。结果β-CTx、P1NP在2组间比较差异有统计学意义(t值分别为4.32和3.07,P<0.01)。β-CTx曲线下面积为0.815,大于P1NP曲线下面积(0.667),当β-CTx判定阈值为472.97 pg/ml时,灵敏度和特异度相对最优。结论高浓度的β-CTx是绝经后女性患者发生骨质疏松性骨折的重要危险因素,其对骨质疏松性骨折的预测价值更高,当老年女性骨质疏松患者β-CTx达到472.97 pg/ml以上水平时预示高骨折风险。
Objective To explore the predictive value of bone turnover markers in the risk of osteoporotic fracture in postmenopausal women. Methods Fifty-one patients with postmenopausal osteoporotic fracture were enrolled in this study. Of the 1 560 patients treated during June 2013-June 2015, 84 were osteoporosis-free fracture-free age-matched postmenopausal women as control group, Serum samples of β-CTx and P1NP of type Ⅰ collagen were detected in 2 groups of patients. The hip or spine BMD of each group was also measured. Through comparative analysis of two groups of related data, and by ROC curve evaluation of β-CTx, P1NP osteoporotic fracture risk. Results The difference of β-CTx and P1NP between the two groups was statistically significant (t = 4.32 and 3.07 respectively, P <0.01). The area under the curve of β-CTx was 0.815, which was larger than the area under the curve of P1NP (0.667). When the β-CTx threshold was 472.97 pg / ml, the sensitivity and specificity were relatively optimal. Conclusion High concentration of β-CTx is an important risk factor for osteoporotic fractures in postmenopausal women, and its predictive value for osteoporotic fractures is higher. When β-CTx in elderly women with osteoporosis reaches 472.97 pg / ml or above indicates a high risk of fracture.